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Rate and Patient Specific Risk Factors for Periprosthetic Acetabular Fractures during Primary Total Hip Arthroplasty using a Pressfit Cup.

Simon S, Gobi H, Mitterer JA, Frank BJ, Huber S, Aichmair A, Dominkus M, Hofstaetter JG

pubmed logopapersMay 26 2025
Periprosthetic acetabular fractures following primary total hip arthroplasty (THA) using a cementless acetabular component range from occult to severe fractures. The aims of this study were to evaluate the perioperative periprosthetic acetabular fracture rate and patient-specific risks of a modular cementless acetabular component. In this study, we included 7,016 primary THAs (61.4% women, 38.6% men; age, 67 years; interquartile-range, 58 to 74) that received a cementless-hydroxyapatite-coated modular-titanium press-fit acetabular component from a single manufacturer between January 2013 and September 2022. All perioperative radiographs and CT (computer tomography) scans were analyzed for all causes. Patient-specific data and the revision rate were retrieved, and radiographic measurements were performed using artificial intelligence-based software. Following matching based on patients' demographics, a comparison was made between patients who had and did not have periacetabular fractures in order to identify patient-specific and radiographic risk factors for periacetabular fractures. The fracture rate was 0.8% (56 of 7,016). Overall, 33.9% (19 of 56) were small occult fractures solely visible on CT. Additionally, there were 21 of 56 (37.5%) with a stable small fracture. Both groups (40 of 56 (71.4%)) were treated nonoperatively. Revision THA was necessary in 16 of 56, resulting in an overall revision rate of 0.2% (16 of 7,016). Patient-specific risk factors were small acetabular-component size (≤ 50), a low body mass index (BMI) (< 24.5), a higher age (> 68 years), women, a low lateral-central-age-angle (< 24°), a high Extrusion-index (> 20%), a high sharp-angle (> 38°), and a high Tönnis-angle (> 10°). A wide range of periprosthetic acetabular fractures were observed following primary cementless THA. In total, 71.4% of acetabular fractures were small cracks that did not necessitate revision surgery. By identifying patient-specific risk factors, such as advanced age, women, low BMI, and dysplastic hips, future complications may be reduced.

Methodological Challenges in Deep Learning-Based Detection of Intracranial Aneurysms: A Scoping Review.

Joo B

pubmed logopapersMay 26 2025
Artificial intelligence (AI), particularly deep learning, has demonstrated high diagnostic performance in detecting intracranial aneurysms on computed tomography angiography (CTA) and magnetic resonance angiography (MRA). However, the clinical translation of these technologies remains limited due to methodological limitations and concerns about generalizability. This scoping review comprehensively evaluates 36 studies that applied deep learning to intracranial aneurysm detection on CTA or MRA, focusing on study design, validation strategies, reporting practices, and reference standards. Key findings include inconsistent handling of ruptured and previously treated aneurysms, underreporting of coexisting brain or vascular abnormalities, limited use of external validation, and an almost complete absence of prospective study designs. Only a minority of studies employed diagnostic cohorts that reflect real-world aneurysm prevalence, and few reported all essential performance metrics, such as patient-wise and lesion-wise sensitivity, specificity, and false positives per case. These limitations suggest that current studies remain at the stage of technical validation, with high risks of bias and limited clinical applicability. To facilitate real-world implementation, future research must adopt more rigorous designs, representative and diverse validation cohorts, standardized reporting practices, and greater attention to human-AI interaction.

DeepInverse: A Python package for solving imaging inverse problems with deep learning

Julián Tachella, Matthieu Terris, Samuel Hurault, Andrew Wang, Dongdong Chen, Minh-Hai Nguyen, Maxime Song, Thomas Davies, Leo Davy, Jonathan Dong, Paul Escande, Johannes Hertrich, Zhiyuan Hu, Tobías I. Liaudat, Nils Laurent, Brett Levac, Mathurin Massias, Thomas Moreau, Thibaut Modrzyk, Brayan Monroy, Sebastian Neumayer, Jérémy Scanvic, Florian Sarron, Victor Sechaud, Georg Schramm, Chao Tang, Romain Vo, Pierre Weiss

arxiv logopreprintMay 26 2025
DeepInverse is an open-source PyTorch-based library for solving imaging inverse problems. The library covers all crucial steps in image reconstruction from the efficient implementation of forward operators (e.g., optics, MRI, tomography), to the definition and resolution of variational problems and the design and training of advanced neural network architectures. In this paper, we describe the main functionality of the library and discuss the main design choices.

Advancements in Medical Image Classification through Fine-Tuning Natural Domain Foundation Models

Mobina Mansoori, Sajjad Shahabodini, Farnoush Bayatmakou, Jamshid Abouei, Konstantinos N. Plataniotis, Arash Mohammadi

arxiv logopreprintMay 26 2025
Using massive datasets, foundation models are large-scale, pre-trained models that perform a wide range of tasks. These models have shown consistently improved results with the introduction of new methods. It is crucial to analyze how these trends impact the medical field and determine whether these advancements can drive meaningful change. This study investigates the application of recent state-of-the-art foundation models, DINOv2, MAE, VMamba, CoCa, SAM2, and AIMv2, for medical image classification. We explore their effectiveness on datasets including CBIS-DDSM for mammography, ISIC2019 for skin lesions, APTOS2019 for diabetic retinopathy, and CHEXPERT for chest radiographs. By fine-tuning these models and evaluating their configurations, we aim to understand the potential of these advancements in medical image classification. The results indicate that these advanced models significantly enhance classification outcomes, demonstrating robust performance despite limited labeled data. Based on our results, AIMv2, DINOv2, and SAM2 models outperformed others, demonstrating that progress in natural domain training has positively impacted the medical domain and improved classification outcomes. Our code is publicly available at: https://github.com/sajjad-sh33/Medical-Transfer-Learning.

Rep3D: Re-parameterize Large 3D Kernels with Low-Rank Receptive Modeling for Medical Imaging

Ho Hin Lee, Quan Liu, Shunxing Bao, Yuankai Huo, Bennett A. Landman

arxiv logopreprintMay 26 2025
In contrast to vision transformers, which model long-range dependencies through global self-attention, large kernel convolutions provide a more efficient and scalable alternative, particularly in high-resolution 3D volumetric settings. However, naively increasing kernel size often leads to optimization instability and degradation in performance. Motivated by the spatial bias observed in effective receptive fields (ERFs), we hypothesize that different kernel elements converge at variable rates during training. To support this, we derive a theoretical connection between element-wise gradients and first-order optimization, showing that structurally re-parameterized convolution blocks inherently induce spatially varying learning rates. Building on this insight, we introduce Rep3D, a 3D convolutional framework that incorporates a learnable spatial prior into large kernel training. A lightweight two-stage modulation network generates a receptive-biased scaling mask, adaptively re-weighting kernel updates and enabling local-to-global convergence behavior. Rep3D adopts a plain encoder design with large depthwise convolutions, avoiding the architectural complexity of multi-branch compositions. We evaluate Rep3D on five challenging 3D segmentation benchmarks and demonstrate consistent improvements over state-of-the-art baselines, including transformer-based and fixed-prior re-parameterization methods. By unifying spatial inductive bias with optimization-aware learning, Rep3D offers an interpretable, and scalable solution for 3D medical image analysis. The source code is publicly available at https://github.com/leeh43/Rep3D.

tUbe net: a generalisable deep learning tool for 3D vessel segmentation

Holroyd, N. A., Li, Z., Walsh, C., Brown, E. E., Shipley, R. J., Walker-Samuel, S.

biorxiv logopreprintMay 26 2025
Deep learning has become an invaluable tool for bioimage analysis but, while open-source cell annotation software such as cellpose are widely used, an equivalent tool for three-dimensional (3D) vascular annotation does not exist. With the vascular system being directly impacted by a broad range of diseases, there is significant medical interest in quantitative analysis for vascular imaging. However, existing deep learning approaches for this task are specialised to particular tissue types or imaging modalities. We present a new deep learning model for segmentation of vasculature that is generalisable across tissues, modalities, scales and pathologies. To create a generalisable model, a 3D convolutional neural network was trained using data from multiple modalities including optical imaging, computational tomography and photoacoustic imaging. Through this varied training set, the model was forced to learn common features of vessels cross-modality and scale. Following this, the general model was fine-tuned to different applications with a minimal amount of manually labelled ground truth data. It was found that the general model could be specialised to segment new datasets, with a high degree of accuracy, using as little as 0.3% of the volume of that dataset for fine-tuning. As such, this model enables users to produce accurate segmentations of 3D vascular networks without the need to label large amounts of training data.

Applications of artificial intelligence in abdominal imaging.

Gupta A, Rajamohan N, Bansal B, Chaudhri S, Chandarana H, Bagga B

pubmed logopapersMay 26 2025
The rapid advancements in artificial intelligence (AI) carry the promise to reshape abdominal imaging by offering transformative solutions to challenges in disease detection, classification, and personalized care. AI applications, particularly those leveraging deep learning and radiomics, have demonstrated remarkable accuracy in detecting a wide range of abdominal conditions, including but not limited to diffuse liver parenchymal disease, focal liver lesions, pancreatic ductal adenocarcinoma (PDAC), renal tumors, and bowel pathologies. These models excel in the automation of tasks such as segmentation, classification, and prognostication across modalities like ultrasound, CT, and MRI, often surpassing traditional diagnostic methods. Despite these advancements, widespread adoption remains limited by challenges such as data heterogeneity, lack of multicenter validation, reliance on retrospective single-center studies, and the "black box" nature of many AI models, which hinder interpretability and clinician trust. The absence of standardized imaging protocols and reference gold standards further complicates integration into clinical workflows. To address these barriers, future directions emphasize collaborative multi-center efforts to generate diverse, standardized datasets, integration of explainable AI frameworks to existing picture archiving and communication systems, and the development of automated, end-to-end pipelines capable of processing multi-source data. Targeted clinical applications, such as early detection of PDAC, improved segmentation of renal tumors, and improved risk stratification in liver diseases, show potential to refine diagnostic accuracy and therapeutic planning. Ethical considerations, such as data privacy, regulatory compliance, and interdisciplinary collaboration, are essential for successful translation into clinical practice. AI's transformative potential in abdominal imaging lies not only in complementing radiologists but also in fostering precision medicine by enabling faster, more accurate, and patient-centered care. Overcoming current limitations through innovation and collaboration will be pivotal in realizing AI's full potential to improve patient outcomes and redefine the landscape of abdominal radiology.

AI in Orthopedic Research: A Comprehensive Review.

Misir A, Yuce A

pubmed logopapersMay 26 2025
Artificial intelligence (AI) is revolutionizing orthopedic research and clinical practice by enhancing diagnostic accuracy, optimizing treatment strategies, and streamlining clinical workflows. Recent advances in deep learning have enabled the development of algorithms that detect fractures, grade osteoarthritis, and identify subtle pathologies in radiographic and magnetic resonance images with performance comparable to expert clinicians. These AI-driven systems reduce missed diagnoses and provide objective, reproducible assessments that facilitate early intervention and personalized treatment planning. Moreover, AI has made significant strides in predictive analytics by integrating diverse patient data-including gait and imaging features-to forecast surgical outcomes, implant survivorship, and rehabilitation trajectories. Emerging applications in robotics, augmented reality, digital twin technologies, and exoskeleton control promise to further transform preoperative planning and intraoperative guidance. Despite these promising developments, challenges such as data heterogeneity, algorithmic bias, and the "black box" nature of many models-as well as issues with robust validation-remain. This comprehensive review synthesizes current developments, critically examines limitations, and outlines future directions for integrating AI into musculoskeletal care.

MedITok: A Unified Tokenizer for Medical Image Synthesis and Interpretation

Chenglong Ma, Yuanfeng Ji, Jin Ye, Zilong Li, Chenhui Wang, Junzhi Ning, Wei Li, Lihao Liu, Qiushan Guo, Tianbin Li, Junjun He, Hongming Shan

arxiv logopreprintMay 25 2025
Advanced autoregressive models have reshaped multimodal AI. However, their transformative potential in medical imaging remains largely untapped due to the absence of a unified visual tokenizer -- one capable of capturing fine-grained visual structures for faithful image reconstruction and realistic image synthesis, as well as rich semantics for accurate diagnosis and image interpretation. To this end, we present MedITok, the first unified tokenizer tailored for medical images, encoding both low-level structural details and high-level clinical semantics within a unified latent space. To balance these competing objectives, we introduce a novel two-stage training framework: a visual representation alignment stage that cold-starts the tokenizer reconstruction learning with a visual semantic constraint, followed by a textual semantic representation alignment stage that infuses detailed clinical semantics into the latent space. Trained on the meticulously collected large-scale dataset with over 30 million medical images and 2 million image-caption pairs, MedITok achieves state-of-the-art performance on more than 30 datasets across 9 imaging modalities and 4 different tasks. By providing a unified token space for autoregressive modeling, MedITok supports a wide range of tasks in clinical diagnostics and generative healthcare applications. Model and code will be made publicly available at: https://github.com/Masaaki-75/meditok.

CDPDNet: Integrating Text Guidance with Hybrid Vision Encoders for Medical Image Segmentation

Jiong Wu, Yang Xing, Boxiao Yu, Wei Shao, Kuang Gong

arxiv logopreprintMay 25 2025
Most publicly available medical segmentation datasets are only partially labeled, with annotations provided for a subset of anatomical structures. When multiple datasets are combined for training, this incomplete annotation poses challenges, as it limits the model's ability to learn shared anatomical representations among datasets. Furthermore, vision-only frameworks often fail to capture complex anatomical relationships and task-specific distinctions, leading to reduced segmentation accuracy and poor generalizability to unseen datasets. In this study, we proposed a novel CLIP-DINO Prompt-Driven Segmentation Network (CDPDNet), which combined a self-supervised vision transformer with CLIP-based text embedding and introduced task-specific text prompts to tackle these challenges. Specifically, the framework was constructed upon a convolutional neural network (CNN) and incorporated DINOv2 to extract both fine-grained and global visual features, which were then fused using a multi-head cross-attention module to overcome the limited long-range modeling capability of CNNs. In addition, CLIP-derived text embeddings were projected into the visual space to help model complex relationships among organs and tumors. To further address the partial label challenge and enhance inter-task discriminative capability, a Text-based Task Prompt Generation (TTPG) module that generated task-specific prompts was designed to guide the segmentation. Extensive experiments on multiple medical imaging datasets demonstrated that CDPDNet consistently outperformed existing state-of-the-art segmentation methods. Code and pretrained model are available at: https://github.com/wujiong-hub/CDPDNet.git.
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